Having a preemie
also means you will be learning a lot about insurance and paperwork. Although
each parent will need to work with their own insurance company to determine
available coverage, we have gathered some tips from parents who have had
gained experience while working out insurance payments.

The common theme:
keep track of the paperwork and always call if you have questions!

You would think that
parents of preemies would get a break when bringing home their baby from
the hospital it’s not always so! In addition to the medicines, the
equipment, the doctor appointments, and oh yeah, the regular baby stuff,
you realize you are in the middle of an insurance fight. Just because
the hospital is listed as a participating provider in your plan, doesn’t
mean that all sections of the hospital are automatically covered under
it. Like most preemie parents, you didn’t exactly have time to discuss
this upon check-in, right? Right. We’ve been there.

So begins the many
phone calls to the insurance company, the various contracted providers
that treated you and/or your child in the hospital. And then the dread
of seeing what large medical bills showed up in today’s mail.

Sound familiar?

So what’s a
preemie parent to do?

Plenty. While the
road to getting all of this resolved has the potential to be long and
frustrating and often feel like a second job, you do have rights and you
do have people on your side despite what you might at first think.

Here are some quick
tips to getting through the confusion:

Breathe
In, Breathe Out. Repeat!

Take a deep breath
and realize that you are not alone and that you will get through this.
Some cases can take up to a year to be totally resolved. Just take it
one step at a time.

Get Organized

First off, invest
in a simple school notebook so you can keep notes on everything as it
progresses. Second, get a large envelope or a set of manila folders so
you can divide up the insurance Explanation of Benefits by provider and
organize from there. Third, in the inside front cover of the notebook,
write up a list of the various providers, their phone numbers, their addresses,
and their office hours. Fourth, make copies of your and your child’s
insurance cards. Doing all of this can save you a lot of time and aggravation.

Professionalism
and Making a Friend Here and There

You are going to be
getting to know a few people during this process your providers (the people
you and/or your insurance company owe money to), the insurance company
(the customer service team to the appeals team). The providers are your
friends, believe it or not. They want to make sure their company gets
that big check so chances are that they have not only been through this
before with other patients but also they may have some sort of template
appeals letter they can provide to you. At the very least you will get
to know them and they will get to know you. All conversations with the
provider should be polite and professional. Make sure that as you update
your notebook with notes on conversations with the insurance company,
etc. that you are doing the same by updating the provider in question.
That way you become less of an account number and more of a human being.

The insurance company
on the other hand, will do its best to confuse the life out of you. Every
time you call into the customer service department, be prepared to wait
on hold for a bit (if you have a speakerphone at home or work, use it!)
Use this time to prepare your set of questions, collect all documents
necessary to the subject at hand, etc.

That way when you
do talk to a representative, you are ready to go. If you are calling to
question the way a claim was handled, simply ask them to go over the claim
in detail with you. After all you are the customer, they should be telling
you what they did and not vice versa.

Take
Notes

This is very important.
Take notes on each and every phone call and make sure to include the date,
time and the person you spoke to (ask for full name and be clear you need
a correct spelling of the name). That is where your notebook comes in
real handy. That way all notes stay in one place and you have a chronological
log of all discussions.

What this will do
is help you work through the confusion of the insurance company. Yes,
they want you to get confused and to just give up. That is what they are
hoping for. Don’t give up!

Persistence
Pays Off

You have the right
to challenge a denied claim, so if a simple phone call to the insurance
company won’t work then move onto writing an appeal letter.

Again these letters
may already be on hand through your doctor’s office.

Give them a call to
check and see if they could assist you with the letter.

Along with the letter
itself, make sure to reference any and all claim numbers and to also provide
copies of the Explanation of Benefits for each